PHNP Purple Book 4th Edition Questions With Complete
Solutions
A client who has been addicted to opioids has not used in 15
days. During your medication management visit, the client
states, "I'm going to die from not having my Opanas. You need
to give me something now." The PMHNP's best response is:
a. "I know you are feeling very uncomfortable and we need to
get you to the emergency room immediately to prevent a
seizure."
b. "I know you are feeling very uncomfortable, let's take your
vital signs and talk about a trial on Catapres to treat your
withdrawal symptoms."
c. "You have been using Opana for a long time and it is going to
take several months for the withdrawal to end. In the meantime,
I will see you weekly."
d. "There is no treatment for opioid withdrawal; you will have to
wait it out."
Correct Answer: B.
Opioid withdrawal symptoms can be treated with central alpha
agonists.
Alice is a 68-year-old woman who presents to you with concerns
about her memory. She explains that her mother and
grandmother both experienced dementia and she wants to do
what she can to prevent this terrible disease. Alice is treated for
hypertension, which is well controlled; other than that, she is in
,good health. She is socially and physically active and
participates in a monthly cooking class, volunteers at her church,
and plays bridge twice a week at the senior center. She says, "I
understand that I am losing brain cells at my age, but I would
still like to keep my mind and body active." Which is the best
response to Alice?
a. "You are correct that you cannot form new brain cells at your
age but you should continue with your activities because they
offer excellent physical and mental health benefits and in turn
will lower your risk for dementia."
b. "Although most brain development occurs early in life, we
still form some new brain cells in a couple of areas of the brain
during adulthood. You should continue with your activities
because they offer excellent physical and mental health benefits
and are neuroprotective."
c. "Scientists now know that we do continue to form new brain
cells throughout the entire brain during adulthood. Continue
with your activities because you are producing new brain cells in
the frontal lobe and this will decrease your risk of dementia."
d. "You should continue the social activities such as bridge,
volunteering, and the book club but should consider the risks
and benefits of physical activities such as dancing. If you were
to fall and break a hip, this could lead to prolonged
hospitalization, loss of independence, and ultimately increase
your risk of dementia."
Correct Answer: B.
,While it was once thought that brain neurons did not regenerate,
we now known that while most brain development occurs early
in life, we continue to form some new brain cells throughout
life. As we age, we need to engage in activities that keep our
brains healthy by encouraging this growth. Examples are diet,
exercise, socialization, and cognitive stimulation.
As a PMHNP working in an outpatient addiction clinic, you
often refer your clients to com-munity AA and NA meetings.
Using Yalom's therapeutic factors, you are aware that peer-led
groups can inspire and encourage other group participants.
Which therapeutic factor is instilled in AA and NA group
members?
a. Hope
b. Altruism
c. Catharsis
d. Existential factors
Correct Answer: A.
Working in support groups such as AA and NA, hearing stories
of others who had similar struggles, instills hope.
A 20-year-old Asian man who was recently diagnosed with
schizophrenia comes to your office for a follow-up appointment.
During the assessment, he talks about his experience in the
group home, thinking that the television is sending him
messages through news anchors during the 10 p.m. evening
news. What symptom is the client describing?
, a. Paranoia
b. Illusions
c. Ideas of reference
d. Neologisms
Correct Answer: C.
Ideas of reference are misinterpretations of incidents and events
that one believes have a direct personal reference to oneself.
As a PMHNP working in a crisis evaluation center, you are
aware that the initial focus of a crisis assessment is on which of
the following?
a. Client's past diagnosis and medication trials
b. Psychosocial history and supports
c. Safety of the client and others
d. Current living situation and coping skills
Correct Answer: C.
In a crisis, the first assessment should be safety of the client and
those near the client.
A mother brings in her 7-year-old son for a psychiatric follow-
up visit with the PMHNP. This is the fourth visit the PMHNP
has had with the client, his mother, and his younger sister,
Renee, now 7 months old. You notice that she has a decrease in
head growth, along with stereotypic motions of the hands, often
Solutions
A client who has been addicted to opioids has not used in 15
days. During your medication management visit, the client
states, "I'm going to die from not having my Opanas. You need
to give me something now." The PMHNP's best response is:
a. "I know you are feeling very uncomfortable and we need to
get you to the emergency room immediately to prevent a
seizure."
b. "I know you are feeling very uncomfortable, let's take your
vital signs and talk about a trial on Catapres to treat your
withdrawal symptoms."
c. "You have been using Opana for a long time and it is going to
take several months for the withdrawal to end. In the meantime,
I will see you weekly."
d. "There is no treatment for opioid withdrawal; you will have to
wait it out."
Correct Answer: B.
Opioid withdrawal symptoms can be treated with central alpha
agonists.
Alice is a 68-year-old woman who presents to you with concerns
about her memory. She explains that her mother and
grandmother both experienced dementia and she wants to do
what she can to prevent this terrible disease. Alice is treated for
hypertension, which is well controlled; other than that, she is in
,good health. She is socially and physically active and
participates in a monthly cooking class, volunteers at her church,
and plays bridge twice a week at the senior center. She says, "I
understand that I am losing brain cells at my age, but I would
still like to keep my mind and body active." Which is the best
response to Alice?
a. "You are correct that you cannot form new brain cells at your
age but you should continue with your activities because they
offer excellent physical and mental health benefits and in turn
will lower your risk for dementia."
b. "Although most brain development occurs early in life, we
still form some new brain cells in a couple of areas of the brain
during adulthood. You should continue with your activities
because they offer excellent physical and mental health benefits
and are neuroprotective."
c. "Scientists now know that we do continue to form new brain
cells throughout the entire brain during adulthood. Continue
with your activities because you are producing new brain cells in
the frontal lobe and this will decrease your risk of dementia."
d. "You should continue the social activities such as bridge,
volunteering, and the book club but should consider the risks
and benefits of physical activities such as dancing. If you were
to fall and break a hip, this could lead to prolonged
hospitalization, loss of independence, and ultimately increase
your risk of dementia."
Correct Answer: B.
,While it was once thought that brain neurons did not regenerate,
we now known that while most brain development occurs early
in life, we continue to form some new brain cells throughout
life. As we age, we need to engage in activities that keep our
brains healthy by encouraging this growth. Examples are diet,
exercise, socialization, and cognitive stimulation.
As a PMHNP working in an outpatient addiction clinic, you
often refer your clients to com-munity AA and NA meetings.
Using Yalom's therapeutic factors, you are aware that peer-led
groups can inspire and encourage other group participants.
Which therapeutic factor is instilled in AA and NA group
members?
a. Hope
b. Altruism
c. Catharsis
d. Existential factors
Correct Answer: A.
Working in support groups such as AA and NA, hearing stories
of others who had similar struggles, instills hope.
A 20-year-old Asian man who was recently diagnosed with
schizophrenia comes to your office for a follow-up appointment.
During the assessment, he talks about his experience in the
group home, thinking that the television is sending him
messages through news anchors during the 10 p.m. evening
news. What symptom is the client describing?
, a. Paranoia
b. Illusions
c. Ideas of reference
d. Neologisms
Correct Answer: C.
Ideas of reference are misinterpretations of incidents and events
that one believes have a direct personal reference to oneself.
As a PMHNP working in a crisis evaluation center, you are
aware that the initial focus of a crisis assessment is on which of
the following?
a. Client's past diagnosis and medication trials
b. Psychosocial history and supports
c. Safety of the client and others
d. Current living situation and coping skills
Correct Answer: C.
In a crisis, the first assessment should be safety of the client and
those near the client.
A mother brings in her 7-year-old son for a psychiatric follow-
up visit with the PMHNP. This is the fourth visit the PMHNP
has had with the client, his mother, and his younger sister,
Renee, now 7 months old. You notice that she has a decrease in
head growth, along with stereotypic motions of the hands, often
